Work engagement and perceived work ability: An evidence-based model to enhance nurses' well-being.

AIMS: The study aims are (a) to test a model developed to estimate the impact of work engagement on work ability as it is perceived by nurses; (b) to test the parameters between work ability and job satisfaction and between job satisfaction and turnover intention. DESIGN: Cross-sectional. METHODS: This study involved 1,024 nurses from January - May 2018. The response rate was 70.7%. The Work Ability Index and the Utrecht Work Engagement Scale were used. Path analysis was performed, both in the whole sample and in age categories (<45yy-≥45yy). Model's parameters and fit indexes were estimated. RESULTS: The comprehensive model was validated through the multi-group approach. Fit indexes were adequate in the general model and in the multi-group testing. Parameters confirmed the association between work engagement and work ability and between work ability and job satisfaction and turnover intention. Parameters highlighted different age-dependent patterns. CONCLUSION: This study states the contribution of work engagement to enhance work ability in nursing profession. Findings contribute in understanding motivational dynamics in nurses and they suggest the use of tailored strategies for different age categories. Further research could address the model to deepen generational patterns in work engagement, work ability, and organizational outcomes. IMPACT: The study highlights how to address nursing management to improve nurses' motivation and work ability and to improve organizational outcomes. Main findings point out different age-dependent patterns to tailor managerial strategies. Healthcare organizations have new elements to design human resources management and to improve job satisfaction and nurses' retention.

Developing policies and actions in response to missed nursing care: A consensus process.

AIM: To support the development of appropriate policies and actions in the field of missed nursing care (MNC). BACKGROUND: There has been an ever-growing international debate on MNC, interventions that nurses have identified as necessary for their patients, but which for various reasons they are unable to provide or are forced to delay. Despite MNC's relevance, its translation into policies and actions has not been documented to date. METHOD: A consensus development method was employed involving (a) a nominal group composed of experts in the field, policymakers and the President of the Regional Nursing Professional Boards, and (b) 218 nurses appointed primarily at the managerial levels. RESULTS: A total of eight consensus statements were approved and organized in a series of sub-statements designed to (1) render the concept of MNC culturally acceptable in the Italian context, with the agreement that compromised nursing care (CNC) is the best term to be used in this field, as a synonym for MNC; (2) measure CNC as a strategy to increase patient safety; (3) select an appropriate CNC measurement tool; (4) optimize CNC measurement; (5) conduct effective CNC data analysis; (6) design and implement interventions to prevent and/or minimize CNC; (7) assess and disseminate findings on interventions' effectiveness; and (8) provide final remarks on the way to move forward. CONCLUSIONS: We developed a process to introduce the phenomenon of MNC in the Italian culture and agreed firstly on the term compromised nursing care, which better reflects MNC's meaning according to the context and facilitates an open discussion on the phenomenon both within and outside the profession. The following consensus statements emerged represent a systematic approach, starting from the measurement and finishing with the re-measurement of the occurrence of MNC after having implemented concrete actions. IMPLICATIONS FOR NURSING MANAGEMENT: The approved consensus statements can guide decision-makers to develop concrete policies and actions that promote the improvement of quality of care and patients' safety by minimizing and/or preventing MNC's occurrence.

Nursing effectiveness in Italy: findings from a grounded theory study.

AIM: The aim of the present study was to conceptualize the basic social process by which nursing intervention affects patient outcomes in Italian daily practice. BACKGROUND: Different frameworks explain the relationship between nursing care and patient outcomes. However, several authors have suggested the need to develop further theory in order to understand this relationship. METHOD: A qualitative study based on a grounded theory approach was undertaken to generate a conceptual description of nursing care in Italy and its relationship to patient outcomes. Data collection and analysis processes were conducted simultaneously in an Italian Teaching Hospital from 2007 to 2009. FINDINGS: Nursing effectiveness (the core variable) expresses the positive effects of the nursing system on patient outcomes, on patient safety and on the multi-disciplinary outcomes. The two interdependent social processes that assure nursing effectiveness are: creating a supportive environment for potentially effective nursing (causative factors); and performing organizational, clinical and collaborative intervention (nursing strategies and consequences). CONCLUSIONS: The factors determining a potentially supportive environment for nursing effectiveness are similar to those documented in the literature but the need for clinical nurses to compensate systematically when this support is not available seems to be unique. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding the basic processes involved in the determination of nursing effectiveness in one country has implications for nursing leaders' decision-making, on National Health Service policy recommendations and on professional development both at national and international levels.

Chief Nurse Executives involuntary turnover in times of health care reforms: Findings from an interpretative phenomenology study.

In recent years, due to several health care system reforms in different countries, an increased involuntary turnover rate of Chief Nurse Executives has been reported around the World. However, no data on their perceived experience of their dismissal have been documented up to now in the European context. Describing the experience of involuntarily dismissed Chief Nurse Executives was the main aim of this interpretative phenomenological study. Data were collected through face-to-face audiotaped interviews performed by involving a purposeful sample of 13 Chief Nurse Executives; data analysis was performed by using the QSR NVIVO 11 software. The Chief Nurse Executives' experience of Being fired is characterized by three main themes: (1) "Health Care Institutions are places influenced by political turbulences"; (2) "My competence and presence in the arena is despised by a range of strategies"; and (3) "Transiting from darkness to light". According to their experience, the reason for dismissal was due to changes in the political climate and the introduction of a new chief executive officer; moreover, Being fired caused a deep pain similar to that experienced during bereavement. In some socio-political contexts, the political climate can influence the role of a Chief Nurse Executive: political membership, whether implicit or explicit, is considered of great value. In other contexts, the Chief Nurse Executives' value is based on professional competences and achieved outcomes. At times of changes in the political climate, the peculiarities of the specific socio-political context should be evaluated as to whether one should anticipate his/her resignation or not.

[Missed nursing care and italian nursing practice: preliminary finding of a consensus conference]. / Missed nursing care e pratica infermieristica italiana:risultati preliminari di una consensus conference.

. Missed nursing care and italian nursing practice: preliminary findings of a consensus conference. In recent years in Italy there has been renewed interest in missed nursing care due to various factors, such as participation in the RANCARE project, with 28 European and non-EU countries, the opportunity to develop international exchanges, specific projects and field based research. We explored a range of ideas and processes, culminating in a conference designed to address specific issues relating to missed nursing care, in the Italian nursing practice. After a preliminary review of the literature on the psychometric properties of the available tools, with the intent of further deepening our understanding of the concept of missed nursing care, its implications for practice, management, education and research. After two days of presentations and discussions, the more than participating nurses agreed on a set of preliminary recommendations regarding missed nursing care and Italian nursing practice. This paper reports on the preliminary consensus findings from the conference.